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原发性软脑膜侧支循环对缺血性脑卒中后快速血流募集的影响。

The impact of native leptomeningeal collateralization on rapid blood flow recruitment following ischemic stroke.

机构信息

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

SFVAMC, San Francisco, CA, USA.

出版信息

J Cereb Blood Flow Metab. 2020 Nov;40(11):2165-2178. doi: 10.1177/0271678X20941265. Epub 2020 Jul 16.

Abstract

The leptomeningeal collateral status is an independent predictor of stroke outcome. By means of optical coherent tomography angiography to compare two mouse strains with different extent of native leptomeningeal collateralization, we determined the spatiotemporal dynamics of collateral flow and downstream hemodynamics following ischemic stroke. A robust recruitment of leptomeningeal collateral flow was detected immediately after middle cerebral artery (MCA) occlusion in C57BL/6 mice, with continued expansion over the course of seven days. In contrast, little collateral recruitment was seen in Balb/C mice during- and one day after MCAO, which coincided with a greater infarct size and worse functional outcome compared to C57BL/6, despite a slight improvement of cortical perfusion seven days after MCAO. Both strains of mice experienced a reduction of blood flow in the penetrating arterioles (PA) by more than 90% 30-min after dMCAO, although the decrease of PA flow was greater and the recovery was less in the Balb/C mice. Further, Balb/C mice also displayed a prolonged greater heterogeneity of capillary transit time after dMCAO in the MCA territory compared to C57BL/6 mice. Our data suggest that the extent of native leptomeningeal collaterals affects downstream hemodynamics with a long lasting impact in the microvascular bed after cortical stroke.

摘要

软脑膜侧支状态是中风预后的独立预测因子。通过光学相干断层血管造影术比较两种具有不同程度固有软脑膜侧支化的小鼠品系,我们确定了缺血性中风后侧支血流和下游血液动力学的时空动力学。在 C57BL/6 小鼠中,大脑中动脉(MCA)闭塞后立即检测到软脑膜侧支血流的大量募集,并在七天的过程中持续扩张。相比之下,在 MCAO 期间和之后的一天,Balb/C 小鼠中几乎没有募集到侧支,与 C57BL/6 相比,梗死面积更大,功能结果更差,尽管在 MCAO 后七天,皮质灌注略有改善。两种品系的小鼠在 dMCAO 后 30 分钟内穿透动脉(PA)的血流减少了 90%以上,尽管 Balb/C 小鼠的 PA 血流减少更多,恢复更少。此外,与 C57BL/6 小鼠相比,Balb/C 小鼠在 MCA 区域的毛细血管渡越时间也表现出更长时间的更大异质性。我们的数据表明,固有软脑膜侧支的程度影响下游血液动力学,并在皮质中风后的微血管床中产生持久影响。

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